{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T11:10:08Z","timestamp":1773745808023,"version":"3.50.1"},"reference-count":28,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T00:00:00Z","timestamp":1773705600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dentistry Journal"],"abstract":"<jats:p>Objectives: This systematic review evaluated the clinical performance and survival of adhesive attachments used as retention elements for removable partial dentures (RPDs) and analyzed associated biological and technical complications. Methods: A systematic electronic search was conducted in PubMed, the Cochrane Library, and Embase in August 2025. Eligible studies included randomized controlled trials, prospective or retrospective clinical studies, and case series with at least 10 patients and a minimum 6-month follow-up. The primary outcome was attachment survival; secondary outcomes included biological and technical complications. Two reviewers independently performed screening, data extraction, and risk of bias assessment using the Newcastle\u2013Ottawa Scale. Due to high heterogeneity, results were analyzed descriptively. This review was prospectively registered (PROSPERO registration number CRD420251116027) and conducted in accordance with PRISMA guidelines. Results: Of 5514 records identified, five longitudinal clinical studies fulfilled the inclusion criteria. Sample sizes ranged from 10 to 123 patients, with follow-up periods between 3 and 270 months. Reported attachment survival ranged from 96% at one year to 61% at 15 years. Technical complications, mainly debonding, occurred in 9% to 18.5% of cases, while biological complications such as caries or abutment fractures were infrequent. All studies were rated as poor-quality owing to missing control groups and incomplete outcome reporting. Conclusions: Within the limitations of the available evidence, adhesive attachments represent a potential option as an invisible retention element for removable prostheses. However, the available findings are based on a limited number of studies with methodological limitations and therefore represent low-certainty evidence. While some studies suggest favorable short-term performance, long-term survival appears to be limited. Debonding was the most frequently reported technical complication, highlighting the technique sensitivity of adhesive cementation. Further well-designed comparative clinical studies with larger sample sizes are required to better clarify their long-term efficacy and clinical indications within removable prosthodontics.<\/jats:p>","DOI":"10.3390\/dj14030174","type":"journal-article","created":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T10:17:44Z","timestamp":1773742664000},"page":"174","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical Performance and Survival of Adhesive Attachments for Removable Partial Dentures: A Systematic Review"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6225-1022","authenticated-orcid":false,"given":"Silwan","family":"Mendes","sequence":"first","affiliation":[{"name":"Department of Reconstructive Dentistry, UZB University Center for Dental Medicine Basel, University of Basel, 4058 Basel, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Florence","family":"Auderset","sequence":"additional","affiliation":[{"name":"Department of Reconstructive Dentistry, UZB University Center for Dental Medicine Basel, University of Basel, 4058 Basel, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8228-6545","authenticated-orcid":false,"given":"Nicola Ursula","family":"Zitzmann","sequence":"additional","affiliation":[{"name":"Department of Reconstructive Dentistry, UZB University Center for Dental Medicine Basel, University of Basel, 4058 Basel, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1841","DOI":"10.4103\/jfmpc.jfmpc_1181_19","article-title":"The epidemiology of edentulism and the associated factors: A literature Review","volume":"9","year":"2020","journal-title":"J. Fam. Med. Prim. Care"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"592","DOI":"10.1177\/0022034513490168","article-title":"Global burden of oral conditions in 1990\u20132010: A systematic analysis","volume":"92","author":"Kassebaum","year":"2013","journal-title":"J. Dent. Res."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1016\/j.prosdent.2017.01.008","article-title":"Removable partial dentures: The clinical need for innovation","volume":"118","author":"Campbell","year":"2017","journal-title":"J. Prosthet. Dent."},{"key":"ref_4","first-page":"139","article-title":"Indications for removable partial dentures: A literature review","volume":"18","author":"Jepson","year":"2005","journal-title":"Int. J. Prosthodont."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"169","DOI":"10.11607\/ijp.6629","article-title":"Long-term observation of post copings retaining overdenture prostheses","volume":"33","author":"Kraljevic","year":"2020","journal-title":"Int. J. Prosthodont."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"147","DOI":"10.11607\/ijp.2959","article-title":"Treatment outcomes with removable partial dentures: A retrospective analysis","volume":"26","author":"Rehmann","year":"2013","journal-title":"Int. J. Prosthodont."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1007\/s00784-024-06090-7","article-title":"Mid-term survival and complications of double-crown-retained removable dental prostheses placed in the dental practice\u2014A retrospective study","volume":"29","author":"Klotz","year":"2024","journal-title":"Clin. Oral. Investig."},{"key":"ref_8","first-page":"138","article-title":"Clinical performance of cast clasp\u2013retained removable partial dentures: A retrospective study","volume":"25","author":"Behr","year":"2012","journal-title":"Int. J. Prosthodont."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"977","DOI":"10.11607\/jomi.7204","article-title":"Telescopic crowns on implants and teeth: Evaluation of a clinical study after 8 to 12 years","volume":"34","author":"Kern","year":"2019","journal-title":"Int. J. Oral. Maxillofac. Implant."},{"key":"ref_10","first-page":"704","article-title":"Retrospective clinical study of 842 clasp retained removable partial dentures with a metal framework: Survival, maintenance needs, and biologic findings","volume":"55","author":"Brandt","year":"2024","journal-title":"Quintessence Int."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"656","DOI":"10.2174\/1874210601610010656","article-title":"Patient\u2019s satisfaction with removable partial dentures: A retrospective case series","volume":"10","author":"Shala","year":"2016","journal-title":"Open Dent. J."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1664","DOI":"10.1016\/j.prosdent.2024.06.020","article-title":"Long-term assessment of the periodontal health of removable partial denture wearers: A systematic review and meta-analysis","volume":"134","author":"Drummond","year":"2025","journal-title":"J. Prosthet. Dent."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1016\/0022-3913(91)90352-W","article-title":"Resin-bonded etched castings with extracoronal attachments for removable partial dentures","volume":"66","author":"Marinello","year":"1991","journal-title":"J. Prosthet. Dent."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1016\/S0022-3913(97)70061-1","article-title":"Clinical performance of resin-bonded fixed partial dentures and extracoronal attachments for removable prostheses","volume":"78","author":"Besimo","year":"1997","journal-title":"J. Prosthet. Dent."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"100","DOI":"10.2186\/jpr.JPR_D_22_00306","article-title":"Outcomes of resin-bonded attachments for removable dental prostheses","volume":"68","author":"Garling","year":"2024","journal-title":"J. Prosthodont. Res."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"460","DOI":"10.11607\/ijp.8337","article-title":"What is the best tooth-supported attachment system for distal-extension removable partial dentures? A systematic review with meta-analysis","volume":"37","author":"Carneiro","year":"2024","journal-title":"Int. J. Prosthodont."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1016\/0300-5712(95)90660-A","article-title":"Durability of resin bonds to a cobalt-chromium alloy","volume":"23","author":"Kern","year":"1995","journal-title":"J. Dent."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1038\/s41415-021-3336-x","article-title":"Predictable bonding of adhesive indirect restorations: Factors for success","volume":"231","author":"Gavriil","year":"2021","journal-title":"Br. Dent. J."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"200","DOI":"10.15171\/joddd.2019.031","article-title":"Evaluation of the effect of different surface treatments on the bond strength of non-precious alloy-ceramic interface: An SEM study","volume":"13","author":"Belkhode","year":"2019","journal-title":"J. Dent. Res. Dent. Clin. Dent. Prospect."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Higgins, J.P.T., Thomas, J., Chandler, J., Cumpston, M., Li, T., Page, M.J., and Welch, V.A. (2019). Cochrane Handbook for Systematic Reviews of Interventions, John Wiley & Sons. [2nd ed.].","DOI":"10.1002\/9781119536604"},{"key":"ref_22","unstructured":"Wells, G.A., Shea, B., O\u2019Connell, D., Peterson, J., Welch, V., Losos, M., and Tugwell, P. (2022). The Newcastle\u2013Ottawa Scale (NOS) for Assessing the Quality of Nonrandomized Studies in Meta-Analyses, Ottawa Hospital Research Institute."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1007\/s10654-010-9491-z","article-title":"Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses","volume":"25","author":"Stang","year":"2010","journal-title":"Eur. J. Epidemiol."},{"key":"ref_24","first-page":"36","article-title":"Resin-bonded etched cast extracoronal attachments for removable partial dentures: Clinical experiences","volume":"7","author":"Marinello","year":"1987","journal-title":"Int. J. Periodontics Restor. Dent."},{"key":"ref_25","first-page":"326","article-title":"Clinical results of partial denture anchorage using extracoronal bonded attachments","volume":"45","year":"1990","journal-title":"Dtsch. Zahnarztl. Z."},{"key":"ref_26","first-page":"5","article-title":"Extracoronal adhesive attachments: Innovative, esthetic option in partial dentures","volume":"7","author":"Marinello","year":"1990","journal-title":"Phillip-J. Zahn\u00e4rztliche Prax."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"636","DOI":"10.1016\/j.prosdent.2020.07.006","article-title":"Attachment-retained removable prostheses: Patient satisfaction and quality of life assessment","volume":"125","author":"Swelem","year":"2021","journal-title":"J. Prosthet. Dent."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1111\/jopr.12395","article-title":"Treatment outcomes based on patients\u2019 self-reported measures after receiving new clasp or precision attachment retained removable partial dentures","volume":"26","year":"2017","journal-title":"J. Prosthodont. Off. J. Am. Coll. Prosthodont."}],"container-title":["Dentistry Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2304-6767\/14\/3\/174\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T10:26:35Z","timestamp":1773743195000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2304-6767\/14\/3\/174"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,17]]},"references-count":28,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,3]]}},"alternative-id":["dj14030174"],"URL":"https:\/\/doi.org\/10.3390\/dj14030174","relation":{},"ISSN":["2304-6767"],"issn-type":[{"value":"2304-6767","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,17]]}}}